Despite centuries of recognition of the contribution of workplace factors to human health, disease, injury, disability, and death, occupational medicine remains an obscure specialty within the health care community. Following passage of the Occupational Safety and Health Act of 1970, there was a rise in the number of accredited residency training programs in occupational medicine, reaching a peak in the mid-90s. Since then, the number of such programs has declined rapidly by almost 25 percent in spite of a recognized shortfall of physicians with formalized training in this area. Rural communities in particular often lack the infrastructure for developing and sustaining a preventive approach to occupational disease and injury especially for specific work sectors such as agriculture and where the hired workforce may constitute the majority of employees. The objective of this proposal to improve public health will be to seek support from NIOSH not only for sustaining and increasing the number of occupational medicine trained physicians, but also to bring a dimension of training which concentrates on the occupational health needs of the rural workforce with special emphasis on agriculture. Specific aims for this training project are to: 1. sustain and. improve the supply of qualified physicians, with specific competency skills, needed to address occupational health concerns in non-urban areas. 2. increase the number of occupational medicine residency graduates with training in agricultural occupational health regionally (Texas). 3. increase training opportunities in agricultural occupational health in 4 other U.S. Public Health regions, through appropriate clinical rotations and field experiences. 4. enhance occupational medicine resident understanding of responsible and culturally appropriate research activities through formal instructional tools, awareness of current research activities, and creation of opportunities for participation in research projects sponsored by the NIOSH Agricultural Centers. 5. nurture partnerships for interdisciplinary clinical experience between regional accredited occupational medicine residency programs and community/migrant health centers through collaboration with the National Center for Farmworker Health (NCFH).